Olfaction in the fetal and premature infant: functional status and clinical implications

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Olfactory function in the human fetus

In humans, four anatomically distinct structures have been described to establish the intranasal chemical senses: the olfactory system, the trigeminal nerve, the vomeronasal organ, and the terminal nerve. Olfactory receptor neurons (ORN) of the main olfactory system are located in the roof of the nasal cavity, connecting through the olfactory nerves to the main olfactory bulbs (OB). Branches of the trigeminal system innervate the entire respiratory epithelium. Although its functionality in

Chemosensory responses in the premature infant

Olfaction was initially gauged in some rare preterm infants by pediatricians and psychologists interested in the state of the human mind at its very beginning [48], [49], [50]. Although these early studies brought somewhat contradictory results, they produced a picture of functional chemosensation in preterm infants. In general, the early experimenters used high intensity odorants, however, and came therefore to conclude that premature (as well as term-born) infants' reactions were mainly

The bridging perinatal brain: learned and evolved chemosensory expectations

Discrete denominations—fetus, newborn, infant—tend to distract from continuities between different developmental stages. The same brain, supporting fundamentally similar psychobiologic processes, transits from the womb to the mother's arms or the incubator. Thus, a perspective on the continuity of these stages helps to understand early perceptual ontogeny in such terms that the postnatal brain remains retrospectively attentive to stimulations encountered in utero, while the prenatal brain is

Potential usefulness of early chemosensory expectations in perinatal care practices

In perinatal care, many nursing or medical procedures require exposure of infants to conditions at odds with sensory expectations derived from prior experience or from evolved predispositions. This section surveys several of these practices, such as the need to raise infants in separation from the mother's body in incubators, to feed them nonorally, or to expose them to recurrent painful procedures. We propose that both brain expectations for odors from the uterine environment and the readiness

Summary

The sense of smell is functional long before birth. It favors the prenatal acquisition of perceptual expectations that the neonatal brain can carry over to face the novelty of the postnatal environment. Thus, olfaction mediates a thread of sensory continuity between the prenatal and postnatal environments [33]. Some “primary” odor expectations, such as the preferential response to the odor of conspecific milk [96], [124], may be the result of either such prenatal experiences or of unconditional

Acknowledgements

The authors acknowledge S. Pihet, D. Mellier, E. Hertling, A Moessinger, D. Malmberg, B. Pierrehumbert, J.P. Lecanuet, A.J. De Casper, C. Granier-Deferre, C. Gaugler, L. Marlier, and P. Mielle for discussion of some of the ideas developed in this article. N. Mutin, S. Gros, and H. Bosc are thanked for their respective logistic, secretarial, and linguistic help.

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